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IOWA DEPT. OF HUMAN SERVICES Iowa Department of Human Services Medicaid/Hawks Review USE ONLY BLUE OR BLACK INK. IOWA DEPT. OF HUMAN SERVICES Due Date Case Number County Number Email Address Phone
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How to fill out medicaid hawk i review

How to Fill Out Medicaid Hawk I Review:
01
Gather necessary documents: Before starting the review process, gather all the required documents such as income verification, medical records, and personal identification.
02
Access the Medicaid Hawk I Review form: Visit the official website of your state's Medicaid program or contact the local Medicaid office to obtain the Medicaid Hawk I Review form.
03
Read the instructions: Carefully read through the instructions provided with the form to understand the requirements and procedures for filling it out.
04
Provide personal information: Begin filling out the form by providing your personal information including your name, address, contact details, social security number, and any other relevant information requested.
05
Income verification: Provide accurate information about your current income, including wages, benefits, and any other sources of income. Attach necessary documents such as pay stubs or tax returns to support your claims.
06
Medical information: Fill out the section related to your medical condition or disability. Include details about any healthcare providers or facilities you have visited, diagnoses received, medications taken, and the impact of your condition on your daily life.
07
Review and accuracy: Review the form thoroughly before submitting it. Ensure all the provided information is accurate, complete, and up-to-date. Double-check for any potential errors or missing sections.
08
Submit the form: Once you are confident that the form is correctly filled out, sign and date it. Follow the instructions on where and how to submit the form, whether it is through mail, online submission, or in-person at a Medicaid office.
Who needs Medicaid Hawk I Review?
01
Individuals currently enrolled in the Medicaid program who are required to undergo a periodic review to determine their continued eligibility.
02
Those who have experienced changes in their income, medical condition, or other factors that may impact their eligibility for Medicaid.
03
Individuals who have been notified by the Medicaid office that they need to complete the Medicaid Hawk I Review process to maintain their benefits.
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